摘要
目的 了解2015年天津市HIV流行株的亚型分布和传播特点。方法 从77例新报告未治疗且CD4^＋T淋巴细胞计数≥200个/μl的HIV-1感染者，提取血浆中RNA，应用反转录和巢式PCR扩增HIV的pol和env区，并测序进行相关分子生物学分析。结果 共获得63例样本的HIV毒株序列结果，亚型依次为CRF01_AE、CRF07_BC、B、CRF55_01B和其他独特型二代重组毒株，分别占46.03%（29/63）、30.16%（19/63）、11.11%（7/63）、4.76%（3/63）和7.94%（5/63）；感染者以性传播为主，其中又以CRF01_AE和CRF07_BC重组亚型为主，除异性传播无B和CRF55_01B亚型外，同性和异性传播者的亚型分布无明显差别。重组毒株的构成比为88.89%（56/63），并首次发现的二代重组亚型8例，包括3例CRF55_01B、2例AE/BC、1例AE/B和1例新型的AE/B/C重组均为男男同性传播；1例AE/BC重组为异性传播。HIV感染者中传播耐药率为5.3%，均为NNRTI类监测性耐药突变L100I；进化分析中3对pol区Bootstrap值均≥98%，env区Bootstrap值均≥80%，调查显示3对样本来源确认有性伴传播关系。结论 天津市HIV感染者中重组毒株不断增加并广泛流行，性传播者中HIV新型二代重组和耐药毒株不断产生并在不同人群和不同地区间传播，应引起高度重视。
Objective To understand the characteristics on the diversity of HIV subtypes and related transmission in Tianjin. Methods A total of 77 newly diagnosed ART-na？ve HIV infectors in 2015 were screened by CD4^＋T cell counts≥200 cells/μl. Viral RNAs were extracted from plasma samples. Reverse transcription PCR and nested PCR were used to analyze the amplification of pol and env gene fragments, sequencing, and related bioinformatics information. Results 46.03% （29/63）, 30.16% （19/63）, 11.11% （7/63）, 4.76% （3/63） and 7.94% （5/63） of the individuals were infected under HIV subtypes CRF01_AE, CRF07_BC, B, CRF55_01B and URFs, with sexual transmission as the major mode of infection. CRF01_AE and CRF07_BC strains were predominant in both MSM and HST populations. The patterns of subtype distribution did not show statistical differences other than subtype B and CRF55_01B strain among HSTs. The proportion of CRFs increased significantly to 88.89%. 8 new second-generation recombinant forms were identified the first time, including 3 CRF55_01B, 2 AE/BC, 1 AE/B and 1AE/B/C among MSMs and 1 AE/BC among HSTs. 5.3% of the NNRTI L100I HIV infectors transmitted the drug-resistant-mutation strain. 3 linkages related to HIV transmission were confirmed through phylogenetic analysis with Bootstrap ≥98% of pol and ≥80% of env. Conclusion The increasing complexity of HIV had been noticed in Tianjin, including the prevalence and transmission of second-generation recombinant and drug-resistant strains through different routes of transmission and in different regions.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2016年第8期1142-1147,共6页
Chinese Journal of Epidemiology
基金
天津市卫生行业重点攻关项目（14KG119）
关键词
艾滋病病毒
亚型
耐药
系统进化分析
Human immunodeficiency virus
Subtype
Drug-resistance
Phylogenetic analysis
